Basic Information
| Provider Information | |||||||||
| NPI: | 1679655278 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PECCA-REYNOLDS | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32 COACHLIGHT DRIVE | ||||||||
| Address2: | |||||||||
| City: | CHATHAM | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07928 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9736650260 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 654 E JERSEY ST | ||||||||
| Address2: | |||||||||
| City: | ELIZABETH | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 072061261 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9089947278 | ||||||||
| FaxNumber: | 9089947054 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/20/2006 | ||||||||
| LastUpdateDate: | 05/23/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 44SCO4651900 | NJ | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.